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Biomedical subjects

J Stefan

Publications and source records attributed to J Stefan.

At least 19 recordsLinked to original sources
PubMed2004

[Burn injuries--contemporary and previous findings].

The study compares findings in fatal burn injuries with respect to age, sex, cause of death, survival period, and complications leading to death. These findings were collected at Department of Forensic Medicine, 3rd Faculty of Medicine in Prague during the periods 1966-1974, 1976-1979, 1981-1989 and 1993-2002. The number of occupational and domestic burn injuries has decreased in recent years. The following reflect some of the current trends and situations: Women are prevalent in the group of patients older than 65. Occupational injuries occurred a most exclusively in men with the average age of 42.6 (median 38 years). Suicide rates have increased to 5.4% (with two thirds of them committed by men). The most common cause of injury was due to combustibles and explosives. Injuries caused by improper use of gas and electrical appliances have increased recently. Survival periods have been extended significantly. They have risen to 20.1 days in the age group 15-64 years with burns of 57.3% of body surface area of 2nd ad 3rd degree in comparison with 16 days in patients with burns of 48.4% of body surface area in 1976-1979. In patients over 65 years with burns of 33.9% of body surface area, the survival period has been extended to 16.8 days in comparison with 13.2 days in cases with total burn skin area of 24.8%. In 224 victims who died between 1993-2002, burn shock was diagnosed in 25.8% of the cases, sepsis in 30.3%, pneumonia in 54.4%, cardiac failure in 28.1%, and pulmonary embolism in 7.5%. Multiple organ failure occurred predominantly in the age group 45-64 years representing 27.5% and myocardial infarction in victims above 65 was 13.9%. Thrombo-embolic complications in cases where the victim was less than 44 years of age were extremely rare.

Adolescent↗
PubMed2001

[Quantification of cerebral contusions using the contusion index].

The submitted results provide evidence that calculation of the contusion index (CI) for objective expression of the extent and depth of cerebral contusion is very suitable for various comparative studies. The authors assessed, using the CI the influence of direction, site of violent action, and age on the extent and depth of cerebral contusion in different types of head injuries. Consistent with the literature, the greatest contusion developed in areas of the frontal and temporal lobes. In case of violence from the back and from the side, in subjects above 50 years of age the CI of contusion par contrecoup was markedly greater than at the site of violence. The highest CI of the whole brain was in case of violence from the side. During falls from major heights or walking during alcohol intoxication the contusion was worse than in casualties during traffic accidents where pedestrians predominated. Fractures of the skull in junior subjects occurred only after an intensity which at the same time led also to the development of more extensive and deeper contusion as compared with older subjects where CI in fractures of the skull and intracranial haemorrhage were markedly smaller.

Adolescent↗
PubMed2001

[Epidemiologic study of fatal injuries autopsied at the Institute of Forensic Medicine of the 3rd Medical School of Charles University Hospital in Vinohrady, Prague, from 1996 to 1999].

In our study comprising 1010 persons who died as a result of injury death at the age of 15-97 years and were autopsied in the Institute of Department of Forensic Medicine of the 3rd Faculty of Medicine and University Hospital Královské Vinohrady, were 748 men and 262 women. 717 died at the site of injury and 293 died from the consequences of the injury in hospital. The most frequent cause of injury death was unintentional deaths (56.14%), followed by suicide (26.83%), murder (12.48%) and occupational injuries (4.55%). Road traffic accidents accounted for 51% of unintentional injury deaths. The most frequent cause of death was traumatic shock (32.67%), followed by injuries of the brain and spinal cord (30.50%). Injuries affect most frequently the head (60.5%) and chest (56.9%). The presence of alcohol in blood was detected at 30.2% of deceased.

Adolescent↗
PubMed2001

[Objective evaluation of thoracic injuries and associated injuries using the Abbreviated Injury Scale and the New Injury Severity Score].

The authors focused attention on objectivization of the severity of chest injuries and associated injuries using the Abbreviated Injury Scale (AIS) and the New Injury Severity Score (NISS). They evaluated injuries detected on post-mortem examination in subjects who died from the sequelae of injuries in the Faculty Hospital Prague 10. The group comprised a total of 90 subjects regardless of sex aged 17-94 years who died in the hospital in 1996-2000. Traffic injuries accounted for 70% deaths, other blunt injuries for 27.8% and only 2.2% were penetrating injuries of the chest. The mean AIS value of the chest was 3.7, the mean value of NISS was 50.7. The NISS value declined in relation to age of the deceased patients and the period of survival. The period of survival varied from 30 mins. to 136 days. The mean NISS value on survival up to 5 hours after injury was 55.0. On comparison of our group we found that the results were consistent with those of American studies.

Abbreviated Injury Scale↗
PubMed2000

A rare case of evisceration.

A case of homicide is described where the body of a young woman was found in the countryside in a state of advanced decomposition. The autopsy revealed that almost all the internal organs were missing, but not due to putrefaction. The thoracic cavity was opened in the professional manner normally used during an autopsy. The remains of the small intestine were tied with strands of hair braided into a thin cord.

Abdominal Injuries↗
PubMed1999

Cytokines IL-1beta, IL-6, and TNF-alpha enhance in vitro growth of bacteria.

We have previously reported that in acute respiratory distress syndrome (ARDS), nonsurvivors have persistent elevation in pulmonary and circulating proinflammatory cytokine levels over time and a high rate of nosocomial infections antemortem. In these patients, none of the proven or suspected nosocomial infections caused a transient or sustained increase in plasma proinflammatory cytokine levels above preinfection values. We hypothesized that cytokines secreted by the host during ARDS may favor the growth of bacteria. We conducted an in vitro study of the growth of three bacteria clinically relevant in nosocomial infections, evaluating their in vitro response to various concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6. We found that all three bacterial species showed concentration-dependent growth enhancement when incubated with one or more tested cytokines and that blockade by specific neutralizing cytokine MoAb significantly inhibited cytokine-induced growth. When compared with control, the 6-h growth response (cfu/ml) was maximal with IL-1beta at 1,000 pg for Staphylococcus aureus (36 +/- 16 versus 377 +/- 16; p = 0.0001) and Acinetobacter spp. (317 +/- 1,147 versus 1,124 +/- 147; p = 0.002) and with IL-6 at 1,000 pg for Pseudomonas aeruginosa (99 +/- 50 versus 509 +/- 50; p = 0.009). The effects of cytokines were seen only with fresh isolates and were lost with passage in vitro on bacteriologic medium without added cytokines. In this study we provide additional evidence for a newly described pathogenetic mechanism for bacterial proliferation in the presence of exaggerated and protracted inflammation.

Acinetobacter↗
PubMed1997

[Immunohistochemical methods in the diagnosis of diffuse axonal injury].

Diffuse axonal injury (DAI) was diagnoses according to axonal reaction proved as balls by Palmgren's silver impregnation and axonal lesions by immunohistochemical investigation of ubiquitin and low molecular weight neurofilaments (68 kD). Diffuse axonal injury was found in 16 cases from a group of 36 persons deceased of craniocerebral trauma (44%). Diagnosis was based on the presence of axonal retraction balls in 15 cases; the balls showed also a striking positivity with antibodies against ubiquitin and low molecular neurofilaments as well. In the last patient who died 10 hours after a head injury, too early for axonal retraction balls to be formed, diagnosis of DAI could be settled because of the presence of axonal swellings immunohistochemically positive for ubiquitin and neurofilaments. A control groups of 6 persons after sudden death showed both axonal widenings and swellings but their immunohistochemistry was negative. Immunohistochemical methods of proving ubiquitin and low molecular weight neurofilaments represent substantial contribution to diagnosis of diffuse axonal injury. Earlier phase of axonal lesions than in simple histology can be observed and histological diagnosis of axonal injury independently confirmed.

Adolescent↗
PubMed1994

[Burns caused by electrical current injuries].

A group of patients who died after thermal injuries was compared with those who died as a result of burns caused by electric current. Attention was focused on the survival time and the most frequent complications. In those who died as a result of electric current the mean survival period was shorter. More frequent complications were pneumonia, shock, severe dystrophic changes of parenchymatous organs, necrosis of the heart muscle, venous thrombosis and embolism of the pulmonary artery.

Adolescent↗
PubMed1994

[Personal experience with detection of myoglobin in the myocardium using the immunoperoxidase method].

The authors used the immunohistochemical reaction with antibodies against myoglobin of the heart muscle in three groups of suddenly deceased subjects with a macroscopically apparent myocardial infarction and revealed focal disappearance of myoglobin in 90%. In the second group of sudden deaths with advanced atherosclerosis without a macroscopically apparent infarction, without a macroenzymatic reaction and without any positive histological finding a disseminated reduction up to complete disappearance of myoglobin from cardiac muscle fibres was observed in 70%. In the third control group of subjects who died from a violent death without advanced coronary atherosclerosis a disseminated reduction or disappearance of myoglobin was recorded only in 26%, and this was the case where death was preceded by massive suffocation. The immunochemical method for detection of myoglobin is very sensitive. Disappearance or reduction of myoglobin in myocardial muscle fibres occurs not only in ischaemic but also in hypoxic conditions.

Adolescent↗
PubMed1993

[Complications of thermal injuries leading to death].

The authors analyzed a group of 194 decreased subjects, 119 men and 75 women aged 15.96 years who suffered thermic damage in the years 1981-1989. As compared with the source of burns in 1966-1974, there was a striking increase of subjects who suffered burns during propane-butane explosions. In the foreground of thanatological findings was pneumonia in 49%, shock in 28.3%, sepsis in 26.8% damage of the upper gastrointestinal tract in 23.7% and thrombotic embolism in 18% of the subjects who died. More than half of them died with normothermia, 25% with hyperpyrexia and more than 20% with hypothermia. As compared with values of LA50 in 1966-1974 an increase occurred which implies a more favourable prognosis of burns. The values of LA50 were higher in particular in in the age group from 15-50 years.

Adolescent↗
PubMed1989

[The value of serologic inflammatory parameters in the diagnosis of alopecia areata].

Even recently, focal processes or inflammatory diseases have repeatedly been discussed as the possible causes of alopecia areata (AA) and corresponding diagnostic measures are still recommended. Therefore, we initially attempted to find definite indications of processes like these in AA patients by means of serologic parameters of inflammation and ESR as well as supplementary clinical focal diagnostics. The data obtained revealed increased titers of antistreptolysin in 2.9% and antistreptococcal DNase B in 25.7%, positive C-reactive protein in 8.6%, positive rheumatoid factor in 4.3%, and elevated ESR in 11.7% of the cases. After these data had carefully been compared to those in healthy persons, only the titer of antistreptococcal DNase B and the ESR were found to be increased. In the majority of the cases, these elevations correlated with concomitant bacterial infections detected by clinical focal diagnostics. Antistreptococcal DNase B titer and ESR seem to be the most appropriate of all our test parameters to provide some indications of a focal process or concomitant inflammatory diseases. The remaining parameters are not indicated in AA.

Acute-Phase Proteins↗
PubMed1989

[Traumatic complications of indirect cardiac massage].

The author analyzed injuries in 238 subjects where before death indirect cardiac massage was applied by skilled health workers. The ribs were fractures in 27.7% and the sternum in 16% of the deceased, injuries of other organs were detected 13 times (5.5%). In women injuries were more frequent and fractures of the sternum markedly more frequent than in men. While in men rib fractures on the left side were more frequent than on the rights side, in women this difference was not observed. Rib fractures were mostly in the medioclavicular line at the level of the 3rd-5th rib. The fractures of the sternum were also most frequently at the level between the 3rd and 5th rib. No fractures of the 10th-12th rib were found. The author observed an age-depunende cy of rib fractures in men and women, while fractures of the sternum were age-dependent only in men. There was no relationship with age as regards injuries of other organs. Only in two deceased subjects the injury which developed during indirect cardiac massage was the immediate cause of death. Once it was rupture of the interval mammary vein with haemorrhage into the mediastinum and haemorrhage into the chest, in the other case rupture of the right ventricle with cardiac tamponade.

Female↗
PubMed1989

[Determination of secretion of ABO group antigens using a immunohistochemical method].

In the assessment of secretor status in deceased subjects in recent years efforts focused on immunohistological examination of those orangs the secretions and epithelial cells of which contain group substances in secretors. By means of the immunofluorescent method group substances A and B were estimated in the secretion of mucinous cells of the sublingual salivary glands of the trachea and Becher cells of the trachea. In 19 of 20 examined subjects in the above glands activity was detected suggesting secretor status, corresponding to the blood group. Using the saturation method, concurrently with same results, group substances A a B were detected in bile.

ABO Blood-Group System↗
PubMed1989

[Transfusion of incompatible blood from the aspect of forensic serology].

Based on their own practice, the authors give an account of the possibility to use forensic serology when resolving problems of transfusion of incompatible blood in the ABO system. Conventional serological examination of erythrocytes and serum of the recipient--because of haemolysis of the administered blood cells--usually does not provide a picture of the antigenic structure of the donor and thus it does not provide evidence on transfusion of incompatible blood. According to practical experience examination of the blood stain of the recipient by the absorption elution test, incl. assessment of group antigens A and B, should be helpful, as the latter can be detected despite haemolysis of red cells. The authors recommend in subjects who died, to supplement the above procedure by the method of immunohistological examination of tissues to define more accurately their antigenic structure in the ABO system.

ABO Blood-Group System↗
PubMed1984

[Determination of age based on the circumference of the aorta].

In a cohort of 207 men at the age of 16 to 85 years and 140 women at the age of 16 to 94 years a very close relationship between age and circumference of ascending part, aortic arch and abdominal aorta was found. The coefficient of multiple correlation of age with the size of aorta was 0.896 in women; residual standard deviation was 6.67 years in men and 8.15 years in women. The relationship between age and the size of aorta was expressed by regression liner equation for each sex separately. The age was calculated by means of this equation and the best results were reached in both sexes in the range of 26 to 65 years. In this age period a deviation greater than 10 years from the real age occurred in the least frequency. In the whole cohort of men this deviation occurred in 21.7% and in the whole cohort of women in 22.8% of persons.

Adolescent↗